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6.CERTIFICATION OF USER OF WETLAND CREDITS The proposed riser of credits hereby certifies that halshe: a)either owns the subject wetland credits or has entered into an agreement to y urchase said credits,subject to the approval of all applicable regulatory authorities and b)has filed appropriate plans,!pe 'fi tions and application forms with all applicable regulatory authorities that describe the wetland or water resource impacts for which h ubjec etland credits will be utilized for mitigation purposes. (Zl l�� tl�� CSL��" ��►�., �� Z-r-) a l 7i 1 Autho ii ed i nature of ro sed User of Credits PRINT Name Date 7.REGULATORY AUTHORITY APPROVAL(S) The llowing authorized representatives of the regulatory authority(ies)identified on page 1 of this application hereby certify that they have: a)verified that the subject wetland credits are deposited in the account of the owner/seller,b)approved a wetland replacement plan or other water resource impact under their jurisdiction,and c)approved the proposed use of the wetland bank credits described herein. PRINT Name of WCA LGU Official Signature of Authorized WCA LGU Official Date PRINT Name of Other Regulatory Official(if any) Signature of Other Authorized Official Date Agency ADDRESS of Other Regulatory Official 8.CERTIFICATION OF OWNER/SELLER OF CREDITS I am the holder of the aforementioned account in the State of Minnesota Wetland Mitigation Bank and hereby certify that: 1)the credits described in this application have either been sold to the user of credits or I will use them to ' mitigate wetland impacts for my own project, 2)1 have received payment in full from the buyer(if applicable), 3)the credits have not been sold or used in any way to mitigate wetland losses other than for the project and location identified in the project site information block on the previous page, 4)the subject wetland credits should be withdrawn my account, 5)1 will not have a negative balance of credits after the subject credits are debited from my account,and 6)the Annual Fee for this account has been paid(or will be with an enclosed check). Authorized Signature of Owner/Seller of Credits Date 9.BWSR APPROVAL AND DEBITING OF ACCOUNT I hereby certify that the credits have been properly debited from the subject account,effective the date of signature. Authorized Signature Date ' Upon approval by BWSR,a copy of this instrument will be mailed to the user of the credits,all regulatory authorities involved,the account holder and the Board Conservationist. A letter will also be sent to the account holder acknowledging the debit and new account balance. IMPORTANT REMINDERS ' 1. The Owner/Seller of the credits is responsible for submittal of this form,containing all required signatures,to the BWSR Wetland Bank Administrator so the affected account can be properly debited. 2. No impacts to any wetland or other water resource may commence until the credits have been debited from the Minnesota ' Wetland Mitigation Bank and a copy of this approval has been mailed to the regulatory authority(ies),the account holder and the user of the credits. 3. It is a criminal offense for a seller of wetland credits to sell credits more than one time. It is the responsibility of the account holder to report any credit sales that are not noted on the most current official BWSR account balance. Page 2 of 2 ' BWSR Form:wca-bank-01-withdrawal.doc 1\1ail to: Bank C'oordinator.. Board of 1\'atcr�� Soil Resources Revised 1/5/2011 520 1-allRoad forth St. Paul, N4N 55155